Long-term omega-3 polyunsaturated fatty acid supplementation reduces the recurrence of persistent atrial fibrillation after electrical cardioversion

Omega-3 Fatty Acids in the Prevention of Atrial Fibrillation Recurrences after Cardioversion: A Meta-analysis of Randomized Controlled Trials

“…The patients of three studies (4,5,8) started to receive the treatment drug 4 weeks before cardioverson while the patients of one study (9) started to take the drug 1 week before cardioversion. In one study (10), omega-3 fatty acid treatment and amiodarone were started after the cardioversion.…”

“…Inadequacies in current therapies for atrial fibrillation have made new drug development crucial. Omega-3 fatty acids are well tolerated (4,5,27) and extensive preclinical studies have been undertaken (12-15, 28, 29). In the study of Kumar et al (5), only 5.4% of patients discontinued fish oil because of gastrointestinal disturbance and no patient on fish oil had a serious adverse event.…”

“…Recent studies have suggested that omega-3 fatty acids in fish oils may have antifibrillatory effects (2,3) and can prevent AF recurrence after cardioversion (4,5). However, these studies have reported conflicting results on their role in preventing AF recurrence after cardioversion.…”

The effects of omega-3 polyunsaturated fatty acids on cardiac rhythm: A critical reassessment

“…Therefore, these authors concluded that n−3 PUFA should not be recommended for patients undergoing cardiac surgery (Armaganijan et al, 2011). Equally ambiguous results have been obtained in from trials that have evaluated the effects of n−3 PUFAs on recurrent and persistent AF; n−3 PUFA treatment has been shown both to reduce (Patel et al, 2009;Nodari et al, 2011;Kumar et al, 2012) and to not alter (Kowey et al, 2010;Kumar et al, 2011a;Ozaydin et al, 2011;Watanabe et al, 2011;Macchia et al, 2013) the recurrence of AF in patients with either paroxysmal or persistent AF. Kowey et al (2010) found that n−3 PUFA treatment (8 g/day for 7 days followed by 4 g/day for 24 weeks) did not alter the recurrence of symptomatic AF in patients with either confirmed paroxysmal AF (n−3 PUFA 52%, 135 of 258 vs. placebo 48%, 129 of 269 participants) or persistent AF (50%, 32 of 64 vs. placebo 33%, 18 of 54 subjects).…”

“…However, as the authors did not control (or report) the amount of n−3 PUFAs ingested nor provide any measure of plasma or erythrocyte n−3 PUFA content, the exact relationship between n−3 PUFAs and AF could not be ascertained. This major deficiency has been addressed in two more recent studies (Nodari et al, 2011;Kumar et al, 2012). A randomized open label study of 178 patients with persistent AF evaluated the effects of n−3 PUFAs on the recurrence of AF following cardioversion assigned to either an untreated group (control, n = 87) or n−3 PUFA group (6 g/day, n = 91).…”